Department of Surgery, Division of Cardiovascular Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.
Taipei Medical University, School of Medicine, Taipei, Taiwan.
J Biophotonics. 2020 Oct;13(10):e202000116. doi: 10.1002/jbio.202000116. Epub 2020 Aug 12.
Near-infrared spectroscopy (NIRS) has been proposed as a noninvasive modality for detecting complications in patients undergoing extracorporeal membrane oxygenation (ECMO), and it can simultaneously reveal the global circulatory status of these patients. We optimized ECMO therapy on the basis of real-time peripheral NIRS probing. Three patients underwent venoarterial (VA) ECMO and one patient underwent venovenous (VV) ECMO. All patients received peripheral ECMO cannulation with routine distal perfusion catheter placement. We designed an experimental protocol to adjust ECMO blood flow over 1 hour. Hemodynamic responses were measured using NIRS devices attached to the calf at approximately 60% of the distance from the ankle to the knee. HbO levels change substantially with adjustments in ECMO flow, and they are more sensitive than HHb levels and the tissue saturation index (TSI) are. NIRS for optimizing ECMO therapy may be reliable for monitoring global circulatory status.
近红外光谱（NIRS）已被提议作为一种非侵入性的方法来检测体外膜氧合（ECMO）患者的并发症，并且它可以同时揭示这些患者的整体循环状态。我们根据实时外周 NIRS 探测来优化 ECMO 治疗。3 名患者接受了静脉-动脉（VA）ECMO，1 名患者接受了静脉-静脉（VV）ECMO。所有患者均接受了常规远端灌注导管放置的外周 ECMO 插管。我们设计了一个实验方案，在 1 小时内调整 ECMO 血流量。使用附在小腿上的 NIRS 设备在距离脚踝到膝盖约 60%的位置测量血流动力学反应。HbO 水平随 ECMO 流量的调整而显著变化，并且比 HHb 水平和组织饱和度指数（TSI）更敏感。用于优化 ECMO 治疗的 NIRS 可能是监测整体循环状态的可靠方法。
